


Stricken

by startwithsparks



Category: Criminal Minds, Law & Order: SVU
Genre: Drug Use, M/M, Therapy
Language: English
Status: In-Progress
Published: 2012-12-07
Updated: 2012-12-07
Packaged: 2017-11-20 14:03:50
Rating: Teen And Up Audiences
Warnings: No Archive Warnings Apply
Chapters: 1
Words: 3,430
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/586162
Author URL: https://archiveofourown.org/users/startwithsparks/pseuds/startwithsparks
Summary: <blockquote class="userstuff">
              <p>In order to help with his migraines, Hotchner sends Reid to see an FBI psychologist in DC. Reid is initially resistant to the suggestion, until he finds out that the doctor is an old friend.</p>
            </blockquote>





	Stricken

**Author's Note:**

> Ratings and additional tags will advance with future chapters.

Spencer tapped his pen erratically against the side of his thigh, a clipboard and a half-completed confidentiality form on lap. Two days ago, Hotchner informed him that he'd made an appointment with an FBI psychologist to talk to Spencer about his "current stressors". He didn't need to elaborate for Spencer to know what he was talking about and why he'd taken these measures, but that didn't make it any easier for him to actually go through with the appointment. It took a lot for him to express his concerns, which he would normally dig his heels in and simply refuse to do, but he thought that Hotchner deserved more than that. He was worried that the psychologist would find something wrong with him and they would desk him, but Hotchner told him that it was better to take a maybe over the certainty that he would be desked if he didn't go at all. Backed into a corner, he had no choice but accept the appointment.

He didn't need to be a profiler or even a genius to tell that the psychologist he was seeing didn't have a permanent residence in this office. The receptionist directed him to a small waiting area outside a conference room, the blinds drawn to the floor all the way across the windowed wall. The rest of the office was a long hall with closed doors, some with doctor's names on plaques outside the doors while others were just shut. For all intents, it looked exactly like any other FBI office, with the exception of the one visiting psychologist who seemed to have been stuck in the most inconvenient place possible.

Spencer raised his hand to his face, rubbing his palm over his forehead and back through his hair before he finished reading over the last few lines of the paperwork and scribbled his signature at the bottom. It didn't matter whether he was in DC, Virginia, or Nevada, these things were all the same. His information couldn't be released to any hospital, business, government facility, or civilian without his signed permission, and all of his files were sealed and confidential, but his physician was required by law to report any violence or threats of violence or terrorist activity. They hadn't always told patients about that last clause, and even now most people didn't even read the fine print, but after some malpractice suits and a lot of controversy between physicians and law enforcement as to exactly what confidentiality covered, they had to start telling people that there were exceptions to the agreement.

He didn't have anything to worry about, though. He was just here to talk about some lingering issues, guilt, depression, addiction. Spencer knew that an addict never truly recovered and that opiate addiction was the hardest of all to combat. It was because the body produced opioids naturally. Endorphins and Endomorphins which regulated feelings of pleasure and arousal were all opioids, as well as the chemicals that regulated pain and appetite. When someone introduced an outside opioid or opiate into the system, it steadily increased the body's threshold for these reactions by stimulating those opioid receptors, which was why they were such potent painkillers. But when that added stimulation was removed, by detoxing and sobriety, the body is unable to produce the level of opioids that had become its norm. That left the addict feeling depleted, depressed, and more sensitive to pain. There were over sixty different kinds of opioids, opiates, derivatives, and antagonists, and most of them were found every day in medicine. Even the most common treatments for the dependency of this family of drugs were other opioids.

There wasn't a lot Spencer could do about that, and he didn't want other drugs, so maybe it was best if he did try to address the other issues instead. He could work through the pain and he could rationalize the guilt, but even he was at a loss for what to do about the more irrational emotions. Hotchner was right, he needed this, but that didn't mean he wanted it.

The receptionist came around the corner, one hand on the wall next to her. "Doctor Reid," she said with a pressed smile, "he's ready for you."

Spencer nodded and pushed himself up, slinging his bag back across his shoulders. He handed off the clipboard for her with a faint "Thank you" and allowed her to lead him back to the conference room, opening the door for him and closing it again behind him. Spencer was still struggling with his bag, not even sure why he put it on like this except that it was habit, and missed looking at the doctor when he walked in. But the other man stood from his seat at the conference table while Spencer was still fiddling with his things and took a few steps towards him.

"Doctor Reid," he said softly.

His gaze snapped up at the familiar voice and a smile broke out across his face. "Doctor Huang," he breathed.

The familiar face was a visible relief to him, and Spencer stopped fussing with his bag for long enough to close the distance between them in a few long strides. George held out his arms, his palms up and cradled in a gesture of openness and warmth.

"May I?" he asked.

Spencer didn't have to ask what he was referring to, he just bit back a grin and nodded. "Of course," he answered, reaching out a little as George pulled him into a hug. He squeezed back, resting his chin on the older man's shoulder. George was at least six inches shorter than him, but that had never been a problem between them before.

"I've missed you," Spencer said, breaking away from the hug and awkwardly adjusting the strap of his bag on his shoulder again.

George smiled, "I've missed you too." He motioned towards the table, letting Reid take the lead and choose his seat before sitting down on the opposite side of the table from him.

Spencer slid the strap of his bag off his shoulder at last and let it lay in his lap. "If I'd known that you were the one I was meeting with, I might not have been so nervous about coming here," he said, folding his hands on top of his bag.

"I didn't know myself until I got in this morning," he replied, "only that there was another FBI agent who needed to talk to someone and my name came up." He gave Spencer a knowing smile, "Any idea how that might have happened?"

"I uh, may have mentioned to Hotch that you were the one who trained me to interview victims, a few times, mostly after he tells me how bad I am at it," Spencer replied with a small sigh and a resigned smile. "I've told him to blame you instead."

"How thoughtful," George grinned.

As they settled into the lull in conversation, Spencer took a moment to survey the room. It was a typical small conference room, with an oblong table that could seat six to eight people depending on how crowded in they were. It wasn't that large, he spent Thanksgiving one year with Prentiss and her dining room table was larger than this. There were a few filing cabinets, a white board, a pull-down projector screen, and all the dry-erase markers on the board were black. It was simple, uniform, and underused to the point of being almost entirely abandoned. He didn't want to look at George just yet, so instead he turned his attention to what was on the table - an intercom in the middle of the table, and a thin file next to George's elbow with a pen sitting on top of it and an FBI coffee cup on the other side.

He wet his lips, "You're not staying?" he asked.

George shook his head, "No," he said. "I'm just here to teach a seminar on interviewing, actually. The FBI is in short supply of people who can handle more sensitive cases. Not every person who sits down across a table from us is someone who needs to be coerced and manipulated in order to get an answer from."

He finally looked up then, seeing the soft smile that had settled firmly on his face. "Some just need you to listen, right?" he murmured.

"See," he nodded, "you did learn something from me."

Spencer lowered his head again, drawing in a deep breath and chewing on his lower lip. George was dressed the same as he ever was - in a button-down shirt and slacks, his tie loose but neat. The only exception was that he was wearing glasses again, to hide the fact that the lines around his eyes were a little more drawn, and his hair was buzzed shorter than Spencer had ever seen it, to similarly obscure a thinning hairline. It didn't concern him at all - quite the opposite, actually, it made him smile. George's vanity always showed in little ways, ways that would be completely overlooked by other people, but it made Spencer feel comfortable, at ease.

"I'm glad it's you," Spencer finally said, lips pressed tightly together, offering a small nod with his words. "And not just because you already know about every terrible thing that's happened to me in the last six years, but because I really don't feel like opening up to anyone else right now. Or ever, if can help it," he finished with a forced smile and an exasperated huff.

George smiled back and nodded, leaning forward a little with his arms resting lightly on the table, fingers laced and thumbs pressed together, upwards. Spencer was still acutely aware of his every tick, but he was also aware that he was concentrating on those things out of distraction, to keep himself from thinking too much about why he was here.

"Why don't we start there," George said, "with what you've told me. Is there anything new, or anything you left out of your emails?"

He inhaled slowly, shaking his head. "I-I don't know," he answered. "There are always things that I keep to myself, just because I don't want to bother anyone else with the details and I don't want anyone to baby me..." which people did regardless, but he tried to ignore it for the most part. "I've been clean for four and a half years and there have been a lot of times I've wanted to pick it up again, but never as much as I did when... when I thought that Prentiss was dead."

George stared back at him for a moment, then shifted to reach for the file, dragging it over in front of him and flipping open the front. "You were having what you described as migraines before that," he said.

"For about six months," he answered, watching George closely. "They sort of, um, come in waves. I'll get a lot of them in a row, then go a week or two without, then one or two, and another couple of weeks..."

"Did you have migraines or tension headaches before this?" he asked, still scanning over the paperwork for some answer that other doctors hadn't found yet.

Spencer narrowed his eyes, "I work for the BAU," he said, "we all have a history of tension headaches."

"Good point," George answered, flipping a page up and glancing at it briefly before looking up again. "Spencer," he said directly, "I need you to tell me the absolute truth now."

He wet his lips nervously and nodded, "Okay."

"In the last four and a half years, have you been absolutely clean? And not just illicit drugs either, I mean everything"

Spencer shook his head. "No," he said, brows furrowing. "I've been taking a lot of ibuprofen and naproxen for general pain. It doesn't do as much as the Dilaudid, but it takes the edge off."

George pushed his glasses back up his nose, "I think you're having rebound headaches," he said simply. "They usually start out as tension headaches or migraines and then as the patient takes more drugs to treat the headaches, the body eventually starts to take the lead and the headaches become chronic. They can range everywhere from very mild to as severe as cluster headaches, and do present with light and sound sensitivity, nausea, dizziness, increased depression and moodiness..."

He just stared back at George, watching him intently. "So I've been doing this to myself?" he said.

George softened his gaze, "It's the third most common type of headache and incredibly common in people with prior opioid dependency," he said gently.

"How do I treat it?" he asked.

He watched as George straightened up in his chair and settled back, not quite a defensive position but bracing himself for Spencer to inevitably react badly to his answer. Spencer folded his hands tightly in his lap and waited. "I'm going to suggest propranolol," he said, "which is used primarily to treat hypertension and severe headaches, but it's also been used to treat phobias and anxiety. If that doesn't work..." he glanced back down, "then we'll have to try amitriptyline or valproate."

"Valproate," he repeated, "that's... Depakote. My mother takes that." He frowned, his breathing getting a little more labored as he felt the heavy weight of anxiety on his chest. This was what he'd always been afraid of. While he logically knew that George wasn't telling him he had the same problems as his mother, his brain whirred rapidly to rationalize the connections. "Do I have..." he stammered softly. "Am I-?"

"No," George said, reaching across the table for one of Spencer's hands, which he reluctantly offered. "I'm not saying that at all. Spencer, I know you." His lips pressed into a thin line, "Schizophrenia is usually diagnosed in the early twenties. In some rare cases it can be diagnosed in late teens, but it's generally frowned upon because a person's brain hasn't finished developing until they're twenty-four or twenty-five. In someone with your exceptional intelligence, any sign of schizophrenia would have manifested far earlier, probably in early to mid-adolescence, but long before you reached your twenties. I was with you in your twenties," he said, "if you showed any signs of being schizophrenic, I would have seen it and I would have made you aware of it."

Spencer nodded, squeezing George's hand. "I just-"

"I know," he murmured.

He fell silent again, slipping his hand out of George's grip to fuss with the zip on his bag instead, gaze lowered and hair falling in lank strands in front of his face. "What if I don't want to take medication?" he asked.

"I won't push it," he shook his head. "I don't believe in forcing people to take medication for anything if they're happier without it, if they aren't hurting themselves or someone else without it. And I know how much you value your brain chemistry."

Spencer breathed a small, defeated chuckle. "It's a catch-22," he said. "I know that my brain is what makes me what I am, but at the same time, I'm afraid it's also what's going to be what destroys me. I'm afraid of taking anything, that it might make me less... well, less exceptional, but I'm also afraid that not taking something is only going to continue this spiral until I can no longer control it."

"There is no spiral," George replied, "at least not the way you think there is. There's only your fear of this spiral and your perception that all the things you've gone through are because of it." He paused, watching Spencer look back up at him, the continued. "Everything from your childhood to what you chose to study, your interest in the FBI and the work you do, your susceptibility to drug dependence, your nightmares, your headaches, your anxieties... you think that it all stems from one source, your mother's illness, and that's not necessarily typical of schizophrenia," he offered, tilting his head forward a little in the hopes that Spencer would take the lead.

He did, and nodded, "It's more typical of obsessive-compulsive disorder," he said.

"Right," George nodded.

"So what do I do about it, if I don't want to take medication?"

George gave him a sympathetic smile, "Take care of yourself."

He broke into an awkward grin, scrunching his shoulders as he drew his lower lip between his teeth. "You know I not good at that."

"I know that you grew up taking care of your mother and now you take care of other people," he said, "and that you've never been a priority to yourself. I knew that when we were together and I know that it hasn't changed in seven years."

"You're right," he shrugged. "Elaborate, though... You're the doctor here, give me a course of treatment."

George tapped the end of his pen on the file and chewed on the inside of his lip. "As difficult as it's going to be, you need to stop treating the headaches completely, it's only making them worse. I could give you something to help, but if you don't want medication you're going to have to power through it. You need to actually eat and sleep once in a while, preferably on a routine, and minimize stress as much as possible."

Spencer rubbed his face, "You now where I work, don't you?"

"I am familiar with the BAU, yes..." he chuckled softly. He sighed, holding his hands out again. "You have a choice, Spencer... you can either continue to live this way, or you can make a change."

"And my choicesare a drastic lifestyle adjustments or medication."

"Basically."

"Can I have some time to think about it?" he asked, looking conflicted and unsure of himself. "You know, weigh the options and make an informed decision."

George nodded slowly, "I'm going back to Oklahoma City tomorrow evening, and I need to have my report to your director before I go. Do you think that you can make a decision by then?"

"Yeah," he murmured, looking down at the table between them. "I just want to do some research on the medication, see what the literature says for myself, and then I'll... let you know." He glanced up for only a second and then pushed away from the table. "Thank you for seeing me..." he said. "I-I've missed you, and um, if I'm ever near Oklahoma City, I'll call."

He slung his bag over his shoulder, brushing his hair out of his face, and started to slink towards the door before George shifted and stood.

"Spencer," he said softly. "I know there's something you're not telling me..." He waited until Spencer stopped his retreat and turned slightly to look back at him to continue. "Would you be more comfortable talking to me someplace where you don't feel like you're being studied?"

His face fell and he nodded. "You know me," Spencer repeated simply, swallowing down a lump in his throat.

"I do, and you know that if we move this to a more casual setting, that I won't be able to treat you anymore after this first session."

Spencer nodded again, "Yes," he said, "and I'll have to make my decision regarding treatment a lot sooner."

"Preferably before you leave this room, to avoid any conflict of interests," George replied.

He drew in a long inhale, scrubbing both hands over his face and then back through his hair, face drawn and no less uncertain than it was a moment ago. He didn't just have a choice to make here, he had several choices to make, and firm decisions had never been his strongest suit. He braced both hands on the back of a chair and leaned forward with a sigh. "So," he started, tipping his head to the side to cast a long sideways glance at George. "How would you like to make me dinner tonight?"

George looked genuinely surprised, an almost blank look striking across his face for a moment before it was replaced with a large smile. "I would love nothing more," he answered. He watched Spencer nod at him and shift back from the table again before turning away to gather up his paperwork.

"And George?"

He glanced back up, "Hm?"

"Can you send that prescription to the Walgreens in Van Ness?" He sucked in a rueful breath, "Low dose, please, to start out with."

George nodded gently, "Of course," he said, "the lowest effective dose, as unobtrusive as possible."

"Thank you," he answered, backing towards the door again. "I'll see you tonight."


End file.
